Subclinical Atherosclerosis in Patients with Cushing Syndrome: Evaluation with Carotid Intima-Media Thickness and Ankle-Brachial Index

Background: Cushing syndrome (CS) has been described as a killing disease due its cardiovascular complications. In fact, chronic cortisol excess leads to a constellation of complications, including hypertension, hyperglycemia, adiposity, and thromboembolism. The main vascular alteration associated with CS is atherosclerosis. Methods: Aim of this study was to analyze carotid intima-media thickness (cIMT) and ankle-brachial index (ABI), two surrogate markers of subclinical atherosclerosis in a consecutive series of CS patients, compared to patients with essential hypertension (EH) and health subjects (HS). Results: Patients with CS showed a significant increase (P<0.05) of cIMT (0.89 +/- 0.17 mm) compared to EH (0.81 +/- 0.16 mm) and HS (0.75 +/- 0.4 mm), with a high prevalence of plaque (23%; P<0.03). Moreover, CS patients showed a mean ABI values (1.07 +/- 0.02) significantly lower respect to HS (1.12 +/- 0.11; P<0.05), and a higher percentage (20%) of pathological values of ABI (<= 0.9; P<0.03). Conclusion: In conclusion, we confirmed and extended the data of cIMT in CS, and showed that the ABI represent another surrogate marker of subclinical atherosclerosis in this disease.